If it hadn’t been for his parents’ insistence he stayed in education, Mr Murali Bhat, consultant in hand and upper limb surgery, would have been a professional gymnast. But he is now hugely grateful for their guidance as he relishes leading innovation in hand surgery and encouraging his colleagues to think outside of the box when it comes to managing patient pathways more efficiently. He completed his orthopaedic training in India and did a fellowship in hand surgery at Nottingham University Hospitals, under the direction of the renowned Professor Timothy Davis. Mr Bhat is a consultant at Spire Gatwick Park Hospital in Surrey and for Surrey and Sussex Healthcare NHS Trust
OPN: What drove you to choose surgery as a career – and orthopaedic surgery in particular?
MB: From the age of seven to 18, I was a national gymnast in India and witnessed many a career ending because of injuries. However, many of the same injuries didn’t end careers for my western counterparts, since surgery was more advanced so I wanted to learn the art of healing sports injuries. Orthopaedics seemed the way to go.
During my orthopaedic training in India, I came across a patient with a nasty wrist injury from a motorcycle accident. It was the first time my boss had come across this injury. I asked if I could research it, which I did. He was so impressed that he let me operate. The result was spectacular. The desire to specialise in wrist and hand surgery was born right there.
OPN: It is clear that the healthcare industry has been greatly impacted by the Covid-19 pandemic, what has been the greatest impact within the orthopaedic industry?
MB: Virtual consultation is one of the biggest changes in the orthopaedic field, which saw rapid adoption during COVID and will be here to stay beyond the pandemic.
Even before Covid-19, I had started to triage patients virtually to manage their pathway more efficiently. It was clear from patient feedback that short and defective low value consultations with long wait times, occurred frequently. I began triaging my patients a week ahead, sending them care plans and custom-made videos about their injury. This enabled those patients who did not require a hospital visit to recover safely at home. Patient satisfaction was nearly 100%. With Covid-19, remote triage became highly relevant, and we expanded this approach across the whole department. I now lead on this service, helping to see nearly 300 patients a week at our “Virtual Fracture Clinic”. I also teach and train other healthcare professionals, including GPs and physiotherapists how to safely perform telemedicine consultations.
OPN: As a surgeon, how do you embrace new technologies to ensure the best patient experience, management strategies and surgical outcomes?
MB: In 2017, five hospitals across the country were chosen to train in the Toyota Production System (TPS) for healthcare – a technique first successfully adopted by Virginia Mason Hospital in Seattle – and I was lucky enough to be part of that. It has completely transformed my approach to everything I do. It teaches you to measure the current state with “value for patient” in mind, before implementing changes or increasing resources. I have also learnt to ‘mistake proof’ every part of the patient pathway. For example, I have a safety check-list which I go through with the team before I start an operation – just like a pilot does before he flies a plane. By going through the checks, everyone on the team relaxes and it leads to good outcomes for the patients. It’s a simple thing – takes just 30 seconds to do – but makes a huge difference.
In terms of new procedures, my ‘signature’ has